Provider Demographics
NPI:1427092808
Name:MATHES, CATHERINE L (MD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:L
Last Name:MATHES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 DICK LONAS RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1382
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:
Practice Address - Street 1:200 FORT SANDERS WEST BLVD STE 301
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3360
Practice Address - Country:US
Practice Address - Phone:865-212-2285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN24164207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3076646Medicaid
TN080081753OtherRR MEDICARE PIN
TN080081753OtherRR MEDICARE PIN
F63251Medicare UPIN
TN3076640Medicare ID - Type UnspecifiedLEGACY PIN